Kids get it.

Children never cease to amaze me.

During the holidays in our office, we had on our checkout desk a simple white Christmas tree the size of an 8oz paper coffee cup. It lit up and was a small part of our festive décor. As one of my patients checked out after an appointment, her daughter went right up to it, took in an audible and pleasantly surprised-sounding breath, and couldn’t help but exclaim, “Oh. It’s so beautiful!” A medical assistant and I just looked at each other and exchanged touched glances at the purity of the emotion.

Children are surprisingly forgiving, too. One minute they are upset about something a friend did, and the next, they can quickly find a way to look past it and be playful again. They are more resilient than we give them credit for. They want to be happy and they want others not to be sad.

Which is why I was both touched – yet not that surprised – at how some 1st graders in Minnesota supported the Viking kicker who missed what should have been a winning field goal in the last few seconds of last week’s football game against the Seahawks. I was happy for my Seattle team, but couldn’t help but feel for Brian Walsh. Anyone who’s ever worked in any field (medicine or otherwise) that involves making and executing critical decisions in an instant understands that type of weight. And like medicine, though football is considered a team sport with many players, in the end, it can be one person who ends up shouldering (or feeling responsible) for a bad outcome. Even the understandably upset Vikings coach, who should lead his team as an example of sportsmanship, made an unsupportive, frustrated quip to the media after the game. Since then, he has provided a better perspective to his team’s loss of the game. And, of course, may people used social media as a platform for malicious commentary without consequence.

As someone who lived and breathed Bulls basketball in Chicago years ago, and now is exposed to some of the real tough challenges in peoples’ lives,  I can truly say that, in the end, “it’s only a game.” And we are – each one of us – human.

Those first-graders know that. Kids know how to bounce back. They know how to rally and support. We should all learn from them in this very real and important game of life.

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You’ve Come a Long Way, Baby

50th Anniversary of the Surgeon General's Report on Smoking and Health

Yesterday marked the 50th anniversary of the landmark Surgeon General’s report on smoking and health. It really wasn’t that long ago that smoking was a way of life. As the author points out in this piece on why people smoke, even doctors had cigarettes in their mouth while examining patients back then. The Surgeon General himself, Dr. Luther Terry, was a smoker until a few months before he made his speech in 1964. And for something so deeply ingrained into the culture, so addictive, and a major part of the economy – the report was given on a Saturday in fear of a negative stock market response – we really have seen a remarkable decline in smoking.

The antismoking campaign is a major public health success with few parallels in the history of public health. It is being accomplished despite the addictive nature of tobacco and the powerful economic forces promoting its use.

–          CDC

We now have a better understanding how diffusely tobacco affects the body. People who smoke are at higher risk of everything we worry about getting: cancer, heart attack, stroke, vascular problems leading to leg amputation, and looking older. I see many adult children of smokers who have never smoked, deterred by their parents’ habit. But many children and young adults continue to experiment with smoking, often thinking that they can quit anytime. Unfortunately, smoking continues to be glorified in other settings. Hollywood practically gives them away, somewhat reminiscent of cigarettes being provided to US soldiers in the past.

We’ve come a long way, but we’ve got more work to do.

Winners, Losers at the Golden Globes

Beautiful dresses, talented actors.… What’s not to like about last night’s Golden Globes? Well, how about this little detail from the NYTimes that surprised me:

 6:27 P.M. |To Smoke or Not to Smoke at The Globes

Here’s the difference between Hollywood on screen and off: cigarettes. On screen they are taboo. If you see one it’s accompanied by some carefully scripted moralizing about the ills of smoking. And even then the folks at scenesmoking.org are wary. But here, they give the things away. Seriously. Out on the smoking balcony where we saw Sean Penn pacing and puffing a couple of years ago, tables are thoughtfully stocked with little glass holders crammed with dozens and dozens of recessed-filtered Parliaments. As for drinking don’t even ask.

— Michael Cieply

I cast no judgment on individuals who smoke. In fact, I cringe when others refer to smoking as “ugly” or “disgusting,” both very strong and judgmental adjectives. My job as a physician is to teach people about the harms of smoking and to help them try to quit when they are ready.

Though Hollywood often seems to live by different rules than “the rest of us,” I am fairly certain they are no more immune from the dangers of smoking. That is why I found this “thoughtful” provision of carcinogens at the Golden Globes to be a poor choice from a health and health economics perspective. People should be allowed to smoke if they wish, but maybe the Golden Globes should reconsider having cigarettes readily available next year.

No one but Big Tobacco wins when it comes to smoking.

————

*As an aside -because I can’t help but comment on the fashion- my three favorite dresses of the Golden Globes were worn by Berenice Bejo (Elie Saab), Rooney Mara (Nina Ricci), and Nicole Kidman (Versace).

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Dear TV Producers, You Forgot to Say “Don’t Try This at Home.”

Confession: I have been watching the reality show The Real Housewives of Beverly Hills. I don’t typically have time to watch television, but I end up attaching myself to one reality series for a season. Most often, it is a design competition or cooking show that I watch once a week, such as Project Runway or Top Chef.

Quite frankly, I don’t take shows like The Real Housewives seriously and often wonder if it is bordering on obscene to have such lavish lifestyles displayed on the televisions of homes across America (and around the world) during these hard economic times. But I was particularly disappointed in some of the footage that was shown on last night’s episode. On the show, one of the castmembers took an unknown amount of xanax (a prescription drug that can cause drowsiness and is used for particular types of anxiety) for a flight and was also filmed drinking alcohol (also an unknown amount, though it appeared to be more than 1 drink) while on it. She was clearly affected by the combination, exhibiting psychomotor slowing and slurred speech that was surprisingly more inappropriate than usual for this particular person. What’s worse is that her friends found her all the more entertaining while overly intoxicated and never once cautioned her (or the audience) against combining xanax and alcohol. As a matter of fact, I would argue, this combo seemed to be promoted by portraying this person as entertaining and funny and by devoting a fair amount of air time to her intoxicated state.

The risks of xanax-plus-alcohol were dangerously downplayed here. Both substances depress the central nervous system and can cause coma and death whe taken in excess quantities or used together. The combination of even small amounts can lead to dangerous levels of sedation, poor judgment, and unsafe situations.

I did a web search on the topic of xanax and alcohol and this particular episode to see if anyone else had commented on the high risk behavior depicted in the show. None of the search results explicitly pointed out the dangers of mixing the two drugs. In fact, most blogposts and articles painted it as “awesome entertainment.” The unfortunate fact is, though, that we now live in a time where more Americans die from prescription drugs than from car crashes.  So what makes for good television ratings makes a doctor like me cringe. Xanax is a high-risk medication. Irresponsible use of high-risk prescription drugs should not be glorified on television.

Dear producers, if you want to put that sort of behavior on TV – which I would rather you didn’t – then at least include a stern cautionary warning about it, even if it is only in writing at the end of the episode.

Hopefully, this particular castmember’s own doctor is watching the show and reminds her at her next appointment not to mix xanax and alcohol. Hopefully.

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